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Cortrosyn Stimulation

Additional Codes

LAB9537

Performing Laboratory

MBMC Main Laboratory

Methodology

Electro-Chemiluminescent Immunoassay (ECLIA)

Specimen Requirements

Specimen Type: Plasma
Container/Tube: Mint-green top (lithium heparin gel)

Specimen Volume: Full tube

Collection Information:

1. Draw baseline specimen before administration of Cortrosyn.

2. Administer Cortrosyn.

2. Draw additional specimens at 30-, and 60-minutes post dose.

3. Label specimens appropriately (corresponding draw times.)

4. Send all specimens to the laboratory together.

Note: Draw times are required on each specimen.

Specimen Transport Temperature

Ambient

Day(s) Test Set Up

Monday through Sunday

Turnaround Time:
STAT: 1 hour after receipt in laboratory
Routine: within 4 hours

Reference Values

Interpretive Data

Reference Values

Cortisol cutoff of 14-15 ug/dL for cortrosyn stimulation testing.

Lack of normal response can be seen in both primary and secondary adrenal failure. Some patients with secondary adrenal failure have normal response to cortrosyn. If pituitary disease is known or strongly suspected e.g. after pituitary surgery), the cortrosyn test alone should not be relied on to exclude adrenal failure.

 

Literature References:

  1. Javorsky BR, Raff H, Carroll TB, et al. New cutoffs for the biochemical diagnosis of adrenal insufficiency after ACTH stimulation using specific cortisol assays. J Endocr Soc. 2021;5(4):bvab022.
  2. Carson JLP and Gronowski AM. New cutoffs for the biochemical diagnosis of Adrenal insufficiency after ACTH stimulation using specific cortisol assays. J. Endocrine Soc 2021;5:1-2.

Current interpret data was last revised 08/12/24

Test Classification and CPT Coding

Test Classification:

This test has been cleared or approved by the U.S. Food and Drug Administration and is used per manufacturer’s instructions.

CPT Code:

80400-ACTH stimulation panel for adrenal insufficiency

82533 x 2-Cortisol

Profile Information

Includes baseline Cortisol and 2 additional, post dose